Abstract
Objectives
This call to action seeks to improve emergency care in Canada for equity-deserving communities, enabled by equitable representation among emergency physicians nationally. Specifically, this work describes current resident selection processes and makes recommendations to enhance the equity, diversity, and inclusion (EDI) of resident physician selection in Canadian emergency medicine (EM) residency programs.
Methods
A diverse panel of EM residency program directors, attending and resident physicians, medical students, and community representatives met monthly from September 2021 to May 2022 via videoconference to coordinate a scoping literature review, two surveys, and structured interviews. This work informed the development of recommendations for incorporating EDI into Canadian EM resident physician selection. At the 2022 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, these recommendations were presented to symposium attendees composed of national EM community leaders, members, and learners. Attendees were divided into small working groups to discuss the recommendations and address three conversation-facilitating questions.
Results
Symposium feedback informed a final set of eight recommendations to promote EDI practices during the resident selection process that address recruitment, retention, mitigating inequities and biases, and education. Each recommendation is accompanied by specific, actionable sub-items to guide programs toward a more equitable selection process. The small working groups also described perceived barriers to the implementation of these recommendations and outlined strategies for success that are incorporated into the recommendations.
Conclusion
We call on Canadian EM training programs to implement these eight recommendations to strengthen EDI practices in EM resident physician selection and, in doing so, help to improve the care that patients from equity-deserving groups receive in Canada’s emergency departments (EDs).
Abstrait
Objectifs
Cet appel à l’action vise à améliorer les soins d’urgence au Canada pour les collectivités méritant l’équité, grâce à une représentation équitable parmi les médecins d’urgence à l’échelle nationale. Plus précisément, ce travail décrit les processus actuels de sélection des médecins résidents et formule des recommandations pour améliorer l’équité, la diversité et l’inclusion (EDI) de la sélection des médecins résidents dans les programmes de résidence en médecine d’urgence (SE) du Canada.
Méthodes
Un groupe diversifié de directeurs du programme de résidence en GU, de médecins résidents, d’étudiants en médecine et de représentants communautaires se sont réunis mensuellement de septembre 2021 à mai 2022 par vidéoconférence pour coordonner une analyse documentaire, deux sondages et des entrevues structurées. Ces travaux ont orienté l’élaboration de recommandations pour l’intégration de l’IDE dans la sélection des médecins résidents en SE au Canada. À l’occasion du Symposium universitaire 2022 de l’Association canadienne des médecins d’urgence (ACMU), ces recommandations ont été présentées aux participants au symposium composé de dirigeants, de membres et d’apprenants de la communauté nationale de la GU. Les participants ont été divisés en petits groupes de travail pour discuter des recommandations et aborder trois questions facilitant la conversation.
Résultats
Les commentaires recueillis lors du symposium ont servi à formuler une dernière série de huit recommandations visant à promouvoir les pratiques de l’IDE au cours du processus de sélection des résidents qui traitent du recrutement, du maintien en poste, de l’atténuation des inégalités et des préjugés, et de l’éducation. Chaque recommandation est accompagnée de sous-éléments précis et réalisables pour orienter les programmes vers un processus de sélection plus équitable. Les petits groupes de travail ont également décrit les obstacles perçus à la mise en œuvre de ces recommandations et décrit les stratégies de réussite qui sont intégrées aux recommandations.
Conclusion
Nous demandons aux programmes canadiens de formation en GU de mettre en œuvre ces huit recommandations afin de renforcer les pratiques d’IDE dans la sélection des médecins résidents en GU et, ce faisant, d’aider à améliorer les soins que les patients des groupes méritant l’équité reçoivent dans les services d’urgence du Canada.
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Change history
14 August 2023
A Correction to this paper has been published: https://doi.org/10.1007/s43678-023-00564-5
Notes
Equity-deserving groups are communities that experience significant collective barriers in participating in society. This could include attitudinal, historic, social, and environmental barriers based on age, ethnicity, disability, economic status, gender, nationality, race, sexual orientation, and transgender status.
Leaky pipeline is the phrase commonly used to describe the progressive loss of capable individuals from academic careers in medicine.
Distance traveled refers to where someone started to where they finish, overcoming a lack of resources, family structure or support, and discrimination of any kind, that is more likely to be a better predictor of lifetime/career success than absolute achievement.
Group fit is the compatibility between individuals and their workgroups.
Equity, diversity, and inclusion is a term used to describe policies and programs that promote the representation and participation of different groups of individuals, including people of different ages, races and ethnicities, abilities and disabilities, genders, religions, cultures, and sexual orientations.
Under-represented minority is a group whose percentage of the population is lower than their percentage of the population in the country.
Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the healthcare system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.
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The original online version of this article was revised: In this article the author name Alexandre Morizio was incorrectly written as Alexandre Morizio Elhalwi.
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Primavesi, R., Patocka, C., Burcheri, A. et al. Call to action: equity, diversity, and inclusion in emergency medicine resident physician selection. Can J Emerg Med 25, 550–557 (2023). https://doi.org/10.1007/s43678-023-00528-9
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DOI: https://doi.org/10.1007/s43678-023-00528-9